MIPH ( Minimally Invasive Procedure for Haemorrhoids )

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 MIPH ( Minimally Invasive Procedure for
Haemorrhoids) in Mumbai
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 MIPH procedure
In 1995, Longo described a new and innovative
operative technique for hemorrhoid. This novel
procedure to treat piles is not a
hemorrhoidectomy. In this technique neither the
anal mucosa and nor the hemorrhoidal tissue is
excised. The procedure of MIPH is performed in
the patient with piles on distal rectal mucosa
and submucosa, proximally to the dentate line.
MIPH hemorrhoidectomy includes excision of a band
of excessive or loose prolapse mucosa and
submucosa within the rectum, proximally to the
hemorrhoidal tissue and fixation of the mucosa by
stapled end to end mucosa anastomosis. This
minimally invasive maneuver occlude the blood
supply of the superior hemorrhoidal artery above
the hemorrhoidal tissue and thus piles is cured
as well as prolapsed mucosa is retracted up.
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Advantages

• The Stapler procedure has definite advantages
  over other treatments available for Piles.
• No external cuts or stitches
• Minimal blood loss
• Minimal pain can be easily managed by painkillers
• Sphincter function is not hampered hence
  voluntary control over motion is preserved
• Faster recovery - Patient can resume work from
  5th day
• Lowest recurrence rate ( 8 ) - This is further
  brought down to lt1 by Mucopexy technique
  introduced by Dr Porwal at HHC
• Safe in diabetics, heart patients and senior
  citizens

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Drawbacks

• Inflammation or Infection it Can be prevented
  with anti-inflammatory agents and antibiotics.
• Urgency ( i.e. need to rush to the toilet )- May
  last for 4-8 weeks. This can be kept under
  control with Kegels exercises
• Bleeding following the procedure ( 6-8 )
• Staple line stricture ( 5 ) - In experienced
  hands it can be prevented with proper positioning
  of staple line
• Recurrence ( 8 ) - With the addition of
  Mucopexy, this can be brought down to lt1

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MEET Dr Ashwin Porwal Founder surgeon healing
hand clinic Consultant Colorectal
Surgeon,M.B.B.S, D.N.B. ( Surgery ),Dip.
Proctology ( Italy ),Dip. Laparoscopy ( EITS-
IRCAD, France ).
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